As noted in the article the World Health Organisation calls for the use of such antibiotics as “critically important to human medicine” and restricts the use of these in agriculture and poultry farming because the continued use of these antibiotics as growth promoters increases the chances of bacteria developing resistance to such drugs, thus leaving them insignificant for treating patients with bacterial infections.

The Bureau claims to have details of how in 2016 tonnes of Colistin was shipped to countries like India, South Korea, Russia and Vietnam. It also reveals how the Indian pharmaceutical companies are openly advertising products containing growth promoting antibiotics. One such company according to the Bureau is Venky’s which supplies meat to major food chains like McDonald’s, Pizza Hut, Dominos and KFC. Also, the company has pledged to phase out use of “critically important antibiotics” in its products in Europe and the USby 2019, no such deadline is set for India which according to the Delhi based Centre for Science and Environment is “double standards”. While Venky’s sells Colistin to farmers in India and does not break any laws, in Europe Colistin is sold to farmers only if it is prescribed by a vet.

India has been termed ad the “epicentre of global drug resistance crisis” and the unchecked use of certain drugs is said to create a “perfect storm” to hasten the spread of superbugs. The poor sanitation and untreated wastage in the country creates a very conducive environment for the spread of superbugs. As stated in the article, according to Timothy Walsh the global expert on antibiotic drug resistance the easy availability and use of Colistin in India is “deeply worrying” and “utter madness”. According to Professor Walsh, the use of Colistin in farms in India would easily spread in the air, contaminate the meat, spread to farm workers and because of the open defecation in villages it will speared to places far and wide through their faeces.

In India patients show a high rate of resistance. As stated in the article around 57 per cent of “Klebsiella pneumoniae bacteria - which commonly cause urine, lung and bloodstream infections - are resistant to last line antibiotics known as carbapenems”. In comparison the figures in UK are well below 1 per cent. According to the article drug- resistant infections kill 58,000 new borns in India every year. NDM-1 called the “nightmare bacteria” was found in a patient in India in 2008 and has speared to the world with over 1,100 confirmed cases in the UK. The article states that it is “far from being the only one spread from India to the world”

The growth promoting antibiotics have been banned in EU since 2006 and made illegal in the US since 2017. Indian ministry has just issued a non-binding advisory letter to all the state governments asking them to keep a check on these substances.

According to the article, in the National Action Plan on AMR published in 2017 the Indian government banned using antibiotics as growth promoters however the plan is not currently linked to any regulatory action.

The future looks grim, with the poultry business booming in India and the liberal use of growth promoting antibiotics. While the drug resistant infections will only rise the doctors in India will be left with no options to treat such patients.

If adequate meaures are not put in place “Colistin as a drug will be dead by 2030.”